Healthcare Provider Details

I. General information

NPI: 1982295010
Provider Name (Legal Business Name): H&A MEDICAL HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 N CENTRAL AVE UNIT 101
GLENDALE CA
91203-3507
US

IV. Provider business mailing address

404 CONCORD ST APT 1
GLENDALE CA
91203-1594
US

V. Phone/Fax

Practice location:
  • Phone: 818-836-4513
  • Fax:
Mailing address:
  • Phone: 213-590-5081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. HAYRAPET HAYRAPETYAN
Title or Position: PRESIDENT
Credential:
Phone: 213-590-5081